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Newsletter Vol. 2, No. 42
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
New Jersey Medicaid has updated the Independent Clinical Laboratory Services Manual with additional HCPCS procedure codes and revised Maximum Fee Allowance Schedule rates for laboratory and pathology services. Billing teams must immediately replace their current subchapter with the attached updated version to ensure accurate reimbursement for independent clinical laboratories.
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What to do
immediately · 5 steps
01Billing team and laboratory management must locate and delete the previous Subchapter HCFA Common Procedure Coding System (HCPCS) in the Independent Clinical Laboratory Services Manual and replace it with the attached updated subchapter.
02Verify all laboratory billing codes in the practice management system match the new HCPCS codes and Maximum Fee Allowance Schedule rates listed in the updated subchapter.
03Communicate the updated fee schedules to all staff involved in claims submission and coding.
04Claims submitted using outdated codes or rates will be subject to denial or adjustment by New Jersey Medicaid.
05Contact Phyllis Valeri Bruschini, Consultant at the Office of the Medical Director, if clarification is needed on specific codes or reimbursement rates.
Original notice
Newsletter Vol. 2, No. 42
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 2, No. 01HighEffective Jan 1, 2025 · Provider NoticeNewsletter Vol. 2, No. 02HighEffective Jan 1, 2024 · ReimbursementNewsletter Vol. 2, No. 03MediumNo effective date · CodingNewsletter Vol. 2, No. 04HighEffective Dec 1, 1991 · Provider NoticeBrowse every New Jersey Medicaid change in the policy list